LATENT HEALTH PROFILES ASSOCIATED WITH INSTITUTIONAL ADMISSION AFTER SNF STAY AMONG MEDICARE PLWH

Abstract Background Health profiles may help identify PLWH at risk for institutional admission after a short-term skilled nursing facility (SNF) stay. Methods We estimated rates of institutional admission in one-year follow-up after discharge from a SNF stay (<100 days) among Medicare FFS beneficiaries with HIV (2014-2019). Latent profile analysis identified subgroups based on prevalent conditions one year prior to discharge including 8 indices: mental health (MH range 0-6), substance use (SU 0-4), cardiovascular conditions (CV 0-9), sensory (SE 0-4), musculoskeletal (MU 0-10), pulmonary (PU 0-2), learning disabilities (LD 0-9), and other chronic conditions (OCC 0-11). Cox models estimated the association between latent profiles and time to institution admission (hospital, nursing home), adjusting for demographics, dual eligibility, HIV treatment; censoring included death and study end. Results The 618 PLWH studied were male (73%), with mean age 60 (standard deviation [sd] 11). Two latent health profiles were: CV+OCC+MH (n=77), median values CV=3, OCC=2, MH=1; healthy (n=541), median 0 for all. Compared to the healthy group, the CV+OCC+MH group had similar days spent in an institute (60 days [96] vs 66 days [96]), and similar hazards for institutional admission in adjusted models (HR:1.09, 95% CI [0.81-1.46]) in one-year after SNF discharge. HIV treatment for ≥80% of the time prior to discharge had lower hazards (HR:0.76 [0.59-0.98]) and dual eligibility had higher hazards (HR:1.32 [1.09, 1.61]) of returning to an institutional setting. Conclusions Latent profiles had similar risk for institutional admission in one-year after discharge from a SNF stay, despite having significantly different contributing factors.


AGE-VARYING COGNITIVE IMPAIRMENT AND SOCIAL SUPPORT AMONG PEOPLE AGING WITH AND WITHOUT HIV
Alexis Bender 1 , Regine Haardörfer 1 , Molly Perkins 1 , David Moore 2 , and Hannah Cooper 1 , 1. Emory University, Atlanta, Georgia, United States,2

. University of California at San Diego, San Diego, California, United States
There is compelling but limited evidence that the combination of HIV, methamphetamine (meth) use, and aging form a deleterious trio that undermines cognitive functioning.Currently, a gap exists in our understanding of the intertwining relationships among drug use, HIV, and cognitive function across biological ages and over time.Interventions to reduce meth use and support brain health among aging PWH are vital and improving social relationships is a promising area of intervention.Cross-sectional and limited longitudinal studies indicate that positive social relationships and social support are associated with better cognitive function among healthy older populations.This association has received limited attention among PWH who use drugs beyond adolescence and young adulthood.This study leverages NIH's prior and ongoing investments in research to develop a new analytic cohort by combining participants from 23 studies at the HIV Neurobehavioral Research program.Enrollment in this cohort spans from 2009-2021.At baseline, our sample consists of 862 people with a mean age of 52 (range 18-81).Most participants are male (73%), White (74%), and over half (61%) are living with HIV.Using a life course perspective and time-varying estimation modeling, we examine age-varying cognitive impairment and variation in cognitive function across age by HIV status, meth use, and social relationships.First, we examine how cognitive impairment changes over time for the full sample then examine the differing transitions/turning points among those aging with and without HIV and meth use.Lastly, we show how positive and negative social relationships alter these trajectories among each group.,6. Hunter College,CUNY,New York City,New York,United States Some newer HIV antiretroviral therapy regimens have been associated with weight gain in populations at risk for obesity.This study examined perspectives on weight change and body image among people living with HIV and the extent to which age and gender have an impact on those attitudes.We conducted interviews with 61 individuals in a Medicaid managed care plan.The age range was 23 to 65 years; 49% were aged 50 or older.The sample was 56% non-Hispanic Black and 31% Hispanic.About half were cisgender men, 36% were cisgender women, and 13% were transgender/ nonbinary individuals.Many participants had weight gain they associated with HIV medications.While experiences varied widely, we found that older and younger participants offered some different perspectives.Younger people, including transgender individuals, more often welcomed weight gain, associating it with better health.Participants aged 50 and older sometimes saw weight gain as a natural part of aging, and spoke of acceptance, whereas younger participants tended to focus on their appearance.Among those with unwanted weight gain, older participants expressed concerns about its negative effect on mobility and comorbid health conditions.Some older women in particular struggled with improving their diets.Healthcare providers should consider these different perspectives and the various challenges individuals face associated with age when advising patients with HIV about weight management.For providers working with older patients with HIV, specific considerations of how increased weight affects mobility and risk for comorbid conditions are warranted.

TECHNOLOGY, DRIVING, AND AGING IN PLACE
Abstract citation ID: igad104.1351

AGING-IN-PLACE TECHNOLOGY: PROGRAMMING TO ADDRESS SOCIAL CONNECTEDNESS AND MENTAL HEALTH
Keith Morgen 1 , and Peter Jacob 2 , 1. Centenary University, Hackettstown, New Jersey, United States, 2. Jewish Family Service of Central New Jersey, Elizabeth, New Jersey, United States According to the National Academies of Sciences, Engineering, and Medicine, the drastic increase of older adult social isolation from the pandemic has contributed to premature death, dementia, anxiety, and suicide.Jewish Family Service of Central New Jersey (JFSCNJ) clients corroborated this phenomenon with 65% meeting the diagnostic criteria for moderate to severe older adult depression or anxiety in 2020.In 2022, JFSCNJ established the Fig Tree Virtual Senior Center, a dynamic program that focused on older adults as they readjust to a post-pandemic world.By addressing social isolation through a Person-Centered Trauma Informed and biopsychosocial approaches, various wellness programs were provided in-home via the use of virtual video programming.Sixteen older adults (age range 68-95 yearsold) were assessed on anxiety and depressive symptoms and social connectedness both prior to and six months following the start of the video programming intervention.Paired samples t-testing found a significant reduction in self-reported anxiety (p=.01) and depressive (p=.05) symptoms after video programming engagement at six-months follow-up.Path analysis using bootstrapping with bias corrected confidence intervals found amount of video programming with a positive and significant indirect effect on both increased social connectedness and improved well-being.Implications for homebound older adult social engagement and well-being programming will be discussed.

GENDER AND AGE DIFFERENCES IN ACCEPTANCE OF ADVANCED DRIVER ASSISTANCE SYSTEMS: INSIGHTS FROM OLDER AUSTRALIANS
Abigail Hansen 1 , Kim Kiely 1 , Tuki Attuquayefio 2 , Diane Hosking 3 , Michael Regan 4 , Ranmalee Eramudugolla 1 , Lesley Ross 5 , and Kaarin Anstey 1 , 1. University of New South Wales,Sydney,New South Wales,Australia,2. UNSW,Sydney,New South Wales,Australia,3. National Seniors Australia,Canberra,Australian Capital Territory,Australia,4. University of NSW Sydney,Sydney,New South Wales,Australia,5. Clemson University,Clemson,South Carolina,United States Advanced Driver-Assistance Systems (ADAS) are in-vehicle technologies that promise to improve driver safety and may help support older drivers to drive safer for longer, however there is little research examining acceptance and use of ADAS among older adults.This study investigated age and gender differences in attitudes to ADAS and use of ADAS.We conducted an online survey of 1330 drivers aged 65 years or older (M=72, SD=6.9, 23% women) in partnership with National Seniors Australia.ADAS use was self-reported, classifying respondents in to users (96%) and non-users (4%).ADAS acceptance was measured by the Partial Automation Acceptance Scale.Linear regression estimated gender and age differences in acceptance.Logistic regression estimated differences in ADAS use by gender, age and acceptance.Older age was associated with higher levels of trust in ADAS (β = 0.032, p = 0.04) and lower perceived ease of use (β = -0.02,p = 0.02).Women were less likely to report ADAS use (β = -0.99,p = 0.008) but had higher levels of trust (β = 0.86, p = 0.001) than men.After adjusting for age and gender, positive attitudes towards ADAS (β = 0.12, p = 0.003) and lower perceived risk (β = 0.22, p = 0.046) were associated with higher levels of ADAS use.Consideration of the gender and age differences may inform future vehicle design, and older drivers may benefit from education on the risks and benefits of ADAS to aid in the acceptance and consequent use of ADAS.